Extended hours can bring a win-win solution
It can be a win-win situation for your practice
Are you looking for a way to keep your patients happy and improve your bottom line? If so, you might consider expanding the hours that you see patients. "Many practices could benefit from having hours that are convenient to patients," says Elizabeth Woodcock, FACMPE, an Atlanta-based health care consultant and director of knowledge management for Physicians Practice Inc.
In fact, Woodcock reports that during her work on the Medical Group Management Association’s annual performance and practices survey, she found that many of the better-performing practices offer extended hours for the convenience of their patients. Most practices focus on adding evening hours, but morning and weekend hours work very well for some practices, Woodcock says. For instance, pediatrician offices and primary care practices find that their patients like coming in before work.
Catawba Pediatric Associates, PA, located in Hickory, NC, is typically open 78 hours a week for normal business hours and more than 80 hours a week when patient demand is high. Patients are scheduled from 8 a.m. to 8 p.m. Monday through Friday and 8 a.m. to 5 p.m. Saturdays and Sunday. The staff may see patients as late as 10 p.m. in the winter, says Deborah Cashion, practice administrator.
The practice normally sees only emergencies after 5 p.m. and charges extra for other visits. The exception is summer, when well-child visits are scheduled after hours at no extra charge. Typical patients are those with ear infections, sore throats, and infants with fever — patients who would normally go to the emergency room.
The pediatric practice’s extended hours are popular with parents as well as payers, Cashion points out. "A lot of managed care companies don’t like for their patients to go to the emergency room. The parents pay a higher co-pay and sit there longer than if they came here," Cashion says.
The Hedges Clinic in Frankfort, IL, finds that many patients are willing to pay extra to see a doctor during "urgent care" hours, says Frank Schibli, practice administrator. "We find the area we are in is fairly affluent, with a lot of dual-income households. Many in our client base are not interested in taking the day off work because they have a sore throat," Schibli says.
The urgent care fees are slightly higher than the fees the practice charges during regular office hours but in no way approach what a patient would pay in an emergency room. Extended hours allow practices to increase their customer satisfaction with little increase in cost, Woodcock says. And there may be other benefits as well. For instance, one pediatric practice found that if it had early morning appointments, after-hours calls were minimized, Woodcock says. "If a parent knows their child can come in at 7 a.m., they’re less likely to call at 3 a.m.," she adds.
The practice found that after-hours telephone calls were reduced by 25% when they expanded their hours to include early morning "Kids’ Express" hours. "Expanded morning hours are a very popular concept for pediatric practices," she says. Other patients, particularly those who work full time, also find that it’s much more convenient to be able to see the doctor early in the morning, early in the evening, or on weekends.
Extended hours also give you an opportunity to maximize the return on your overhead. "One of the most common mistakes physicians make is not to leverage their facility," Woodcock adds. Maximizing your hours of operation gives your practice an opportunity to leverage its overhead costs, she says. The typical physician practice spends 5% to 10% of every dollar it takes in on the facility, she points out. You’re paying for your facility 24 hours a day, seven days a week, no matter how many hours you use it.
For instance, if you see patients from 9:30 a.m. to 11:30 a.m. and then again from 1:30 p.m. to 4:30 p.m., you’re using your facility to make money for five hours a day even though you’re paying for it 24 hours a day. "The landlord isn’t giving them a break for the extra 19 hours a day when they aren’t seeing patients. If a practice extends its office hours just by one hour a day, it’s essentially getting the use of your office for free for five hours a week," Woodcock says.
Many practices run out of space and have to move to another facility because they don’t have enough exam rooms, Woodcock says, adding that many of these practices actually see patients only a few hours a day. Woodcock tells of working with a busy OB/GYN practice that opened another office and started seeing patients from 9 a.m. to 4 p.m. at both offices instead of being open from 7 a.m. to 7 p.m. every day.
An overhead shock
"They were shocked that their overhead was so much higher. But now, they are actually paying for what they were getting free in the early morning and evening," she says. When the practice was open from 7 a.m. to 7 p.m., they were seeing patients for 12 hours a day. Now, they’ve increased their office hours by two hours a day, but they doubled the facility cost, she points out.
Expanding office hours can be beneficial to physicians as well because it gives them a chance for more flexible hours, Woodcock points out. Most of the time, each doctor still works the same number of hours per week, but they are just working at different times, she says.
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